Who is a good candidate for this procedure, and what are the contraindications?

Ideal candidates have severe emphysema with significant hyperinflation, limited exercise capacity despite optimal medical therapy, and no active smoking for at least 6 months. Key contraindications include large bullae, active pulmonary infection, significant pulmonary hypertension, and absence of interlobar fissure completeness (which prevents valve sealing). A thorough evaluation with CT scan, pulmonary function tests, and echocardiography is mandatory to confirm suitability.